Multiple peer group self-identification and adolescent tobacco use.

Associations between peer group self-identification and smoking were examined among 2,698 ethnically diverse middle school students in Los Angeles who self-identified with groups such as Rockers, Skaters, and Gamers. The sample was 47.1% male, 54.7% Latino, 25.4% Asian, 10.8% White, 9.1% Other ethnicity, and 59.3% children of immigrant parents. Multiple group self-identification was common: 84% identified with two or more groups and 65% identified with three or more groups. Logistic regression analyses indicated that as students endorsed more high-risk groups, the greater their risk of tobacco use. A classification tree analysis identified risk groups based on interactions among ethnicity, gender, and group self-identification. Psychographic targeting based on group self-identification could be useful to design more relevant smoking prevention messages for adolescents who identify with high-risk peer groups.

Correlates of overweight status in Chinese youth: an East-West paradox.

OBJECTIVE: To examine the odds of overweight and related correlates in Chinese adolescents. METHOD: Cross-sectional study in 9023 adolescents. RESULTS: Chinese youth were more likely to be overweight if they spent more time being sedentary; slept <7 hours/night; were male; were younger; participated more in vigorous physical activity; and had higher levels of parental education, a higher frequency of vegetable intake, and a lower frequency of sweet/fast food intake. CONCLUSIONS: Overweight-related correlates seem to play different roles in the Chinese culture than in Western cultures. This may be due to culture-specific perceptions and changes in lifestyle accompanying socioeconomic transitions.

Understanding the effect of social capital on the depression of urban Chinese adolescents: an integrative framework.

Using data from an ongoing longitudinal study of 5,164 adolescents and their parents from seven cities in mainland China, this study investigated how social capital embedded in the family and the community, together with family human capital and financial capital, influenced the depressive symptoms of urban Chinese adolescents within an integrative framework. The structural equation modeling results suggested that higher community social capital was associated with lower level of adolescent depressive symptoms and was the strongest predictor among all these contextual factors. Family social capital played a significant role in mediating the effects of all other contextual factors on adolescent depressive symptoms. Unexpectedly, higher family financial capital predicted increased depressive symptoms both directly and indirectly through its negative effect on family social capital. As for gender, female adolescents reported more depressive symptoms as a result of less available family social capital. Implications of these findings for theory, practice, policy, and future research are discussed.

Risk factors for adolescent smoking in urban and rural China: findings from the China seven cities study.

Cigarette smoking is rising among urban Chinese adolescents and poses a significant public health concern. The majority of Chinese youth live in rural areas, but most research on the risk factors for smoking has been conducted in urban areas of China. This study examined the associations between parental smoking, peer smoking, and low refusal self-efficacy and smoking among urban and rural Chinese youth. This analysis used a cross-sectional sample of 3412 ninth grade students in urban and rural areas under the administrative jurisdiction of seven large cities in China. Multilevel logistic regression models were used to associate the risk factors with lifetime and current smoking, separately in boys and girls. Adolescent smoking was not strongly associated with parental smoking. However it was strongly associated with peer smoking and low refusal self-efficacy across both the urban and rural samples. Students with lower refusal self-efficacy were approximately 5-17 times more likely to be lifetime or current smokers than those with higher refusal self-efficacy. Smoking prevention interventions in China may need to focus on raising adolescents' refusal self-efficacy.

Tobacco use among youth and adults in Mainland China: the China Seven Cities Study.

OBJECTIVE: The China Seven Cities Study (CSCS) monitors geographic and temporal trends in tobacco use among adolescents and adults in seven cities throughout Mainland China: Harbin, Shenyang, Wuhan, Chengdu, Kunming, Hangzhou, and Qingdao. This article presents the methodology and prevalence data from the baseline survey of the CSCS, conducted in 2002. METHODS: Stratified random samples of middle schools, high schools, and colleges were selected within each city. Students and their parents completed self-report surveys of their tobacco use. Data were obtained from 6138 middle school students, 5848 academic high school students, 2448 vocational high school students, 2556 college students, and 25 697 parents. RESULTS: Smoking prevalence varied across age groups, school types, genders, and cities. Past-month smoking prevalence was 9% among middle school students, 8% among academic high school students, 26% among vocational high school students, 21% among college students, and 40% among parents. Smoking prevalence was higher among males than among females, with larger gender disparities among adults than among youth. Smoking also varied across cities, with higher smoking prevalence in southwestern cities and lower prevalence in coastal cities. Intraclass correlations of students within schools are presented to inform statistical power estimates for further research in China. CONCLUSIONS: These results provide a baseline for future longitudinal studies of smoking in these cities and identify demographic groups at risk for tobacco-related disease. Effective smoking prevention programmes for youth and smoking cessation programmes for adults are needed in China, especially in the lower-income southwestern cities and in vocational high schools throughout the country.

Influences affecting adolescent smoking behavior in China.

This study examined multiple influences on the use of tobacco by adolescents in China. Using the theory of triadic influences as a guide, we selected interpersonal, attitudinal/cultural, and intrapersonal constructs from baseline data to predict adolescent smoking 1 year later. We used prospective data from middle and high school students (N = 11,583) and their parents from the China Seven Cities Study, a longitudinal study that is evaluating the effects of changing economic and social factors on health behaviors including tobacco use. A multilevel regression analysis provided some support that each of the influences in the theory of triadic influences affects adolescent smoking in China. After adjusting for important confounders including age, gender, socioeconomic status, and smoking behaviors (lifetime and past 30-day) at baseline, we found significant risk factors within each of the three categories, including interpersonal influences (parental monitoring, good friend smoking, and peer smoking), attitudinal/cultural influences (school academic ranking, initial liking of smoking, and the meaning of smoking), and intrapersonal influences (susceptibility to smoking, and low self-confidence to quit smoking). Results suggest that the etiology of smoking among adolescents in China might be similar to that observed in western countries and that some of the techniques used successfully in prevention programs in those countries might be useful guides when developing prevention programs in China.

Meanings of smoking and adolescent smoking across ethnicities.

PURPOSE: To develop insight into population-specific meanings of smoking in our highly multicultural middle schools in order to provide effective and appropriate tools for smoking prevention efforts. METHODS: We used focus group interviews to develop the Meanings of Smoking Index (MSI), a nine-item scale that uses a "mark all that apply" strategy to assess what smoking means to children who have tried smoking as well as to those who are susceptible to smoking. In 24 public and parochial middle schools in the greater Los Angeles area, 2336 7th graders (1483 Latino, 565 Asian/ Pacific Islander and 288 white, 55.2% of the sample was female) completed the MSI as part of a school-based trial of culturally-targeted smoking prevention strategies. Items were rank ordered according to salience (rate of endorsement) and relevance (strength of relationship with lifetime smoking) across the entire sample and separately for Hispanic/Latino, Asian/Asian-American and white respondents. Spearman correlation coefficient was used to compare results between ethnicities. RESULTS: The most frequently endorsed meanings were similar across ethnicities. Magnitude of associations between smoking behaviors and meanings were dissimilar across ethnicities. The meaning with the strongest relationship to lifetime smoking for whites and Latinos was "it helps me study" (OR 3.4 and 2.6 respectively), and for Asians was "don't want to make another smoke alone" (OR 5.4). CONCLUSIONS: We have shown previously that interventions on meanings of eating behaviors changed dietary behaviors in adolescents. The present findings suggest that meanings are powerful determinants of adolescent smoking in culturally diverse populations and could offer powerful intervention tools to prevent adolescent smoking.

Ethnic variation in parenting characteristics and adolescent smoking.

PURPOSE: To examine ethnic variation in parenting characteristics and in associations among parenting characteristics and adolescent smoking, and to assess the strength of those associations separately by ethnic subgroup. METHODS: Data were collected from a diverse sample (48.4% Hispanic/Latino, 22.9% Asian, 12.1% Non-Hispanic white, and 16.6% Multiethnic) of 1846 Southern California 6th-graders (mean age 11.3 years). Lifetime smoking and parenting characteristics (parental smoking status, adolescents' perceptions of parent-child communication, and parental monitoring) were assessed. Across ethnic groups, descriptive statistics for parenting and smoking variables were calculated and compared. Logistic regression analyses controlled for demographics (socioeconomic status, generation status, family structure, age, and gender) and interaction terms (parenting characteristics x ethnicity), and were also run separately by ethnicity. RESULTS: Asian adolescents reported less parental monitoring than Latino/Hispanics and less parental communication than other ethnic subgroups. Odds ratios indicated parental monitoring (OR =.63; CI =.53-.74; p <.001) and parental communication (OR =.73; CI =.62-.86; p <.001) were protective whereas parental smoking (OR = 1.48; CI = 1.18-1.87; p <.01) was a risk factor for smoking. Relative to Latinos, parental monitoring (OR =.50; CI =.26-.95; p <.05) was more protective, and parental communication (OR = 2.44; CI = 1.15-5.17; p <.05) less protective for white adolescents. All parental characteristics were significantly associated with Latino/Hispanics smoking. Parental monitoring was significantly associated with Multiethnic and white smoking. No parenting characteristics were significant for Asians. CONCLUSION: Ethnic differences in parenting characteristics and adolescent smoking should be considered when designing prevention curriculum. Future research should investigate the nature of parent-child communication among Asian immigrant populations.